Need for and Receipt of Substance Use Treatment among Blacks

In Brief
  • Combined 2003 to 2011 data indicate that blacks were less likely than persons of other racial and ethnic groups to need alcohol use treatment in the past year (6.8 vs. 7.8 percent) but more likely to need illicit drug use treatment (4.1 vs. 3.0 percent)
  • Among persons in need of alcohol or illicit drug use treatment, blacks were more likely than persons of other racial and ethnic groups to receive treatment at a specialty facility in the past year (15.2 vs. 9.6 percent)
  • Among individuals who needed but did not receive treatment in the past year, blacks were more likely than persons from other racial and ethnic groups to feel the need for and make an effort to get treatment (2.8 vs. 1.4 percent)

The 2010 Census notes that 12.3 percent of the population (38.9 million people) are non-Hispanic African-Americans or blacks (hereafter called "blacks").1 The Substance Abuse and Mental Health Services Administration (SAMHSA) is committed to reducing disparities in access to and quality of care for racial and ethnic minorities.2 The overall health and well-being of the Nation is improved by the extent to which the entire population has access to substance use treatment if it is needed. Understanding whether blacks with alcohol and illicit drug abuse problems seek and receive specialty treatment may help improve treatment and outreach programs for this population.

The National Survey on Drug Use and Health (NSDUH) gathers information about needs for substance use treatment, use of services, and reasons people do not receive treatment. NSDUH classifies persons as needing substance use treatment if they meet the criteria for substance dependence or abuse (based on symptoms they report) or if they received substance use treatment at a specialty facility in the past year.3,4,5 Respondents are also asked if there was a time in the past 12 months when they felt they needed substance use treatment.

This issue of The NSDUH Report looks at the need for and receipt of substance use treatment among blacks and persons from other racial and ethnic groups aged 12 or older.6 Estimates in this report are annual averages based on combined 2003 to 2011 data.


Need for and Receipt of Specialty Treatment in the Past Year

Among those aged 12 or older, blacks and persons from other racial and ethnic groups were equally likely to need treatment for substance use in the past year. That is, 9.1 percent of blacks (2.6 million persons) and 9.3 percent of persons from other racial and ethnic groups (20.4 million persons) needed treatment for illicit drug or alcohol use (Figure 1). Although blacks were less likely than persons from other racial and ethnic groups to need treatment for alcohol use (6.8 vs. 7.8 percent), they were more likely to need treatment for illicit drug use (4.1 vs. 3.0 percent).

Figure 1. Need for Substance Use Treatment in the Past Year among Blacks Aged 12 or Older, Compared with Persons of Other Races/Ethnicities: 2003 to 2011
This is a bar graph comparing need for substance use treatment in the past year among blacks aged 12 or older, compared with persons of other races/ethnicities: 2003 to 2011. Accessible table located below this figure.

Figure 1 Table. Need for Substance Use Treatment in the Past Year among Blacks Aged 12 or Older, Compared with Persons of Other Races/Ethnicities: 2003 to 2011
Races/Ethnicities Need for Alcohol
Use Treatment*
Need for Illicit Drug
Use Treatment*
Need for Illicit Drug
or Alcohol Use Treatment
Blacks 6.8% 4.1% 9.1%
Persons of Other Races
   and Ethnicities
7.8% 3.0% 9.3%
*Difference between blacks and persons of other races and ethnicities is significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health (NSDUHs), 2003 to 2005, 2006 to 2010 (revised March 2012), and 2011.

Among those aged 12 or older in need of substance use treatment, blacks were more likely than persons from other racial and ethnic groups to receive specialty treatment. An estimated 403,000 blacks (15.2 percent) and 2.0 million persons from other racial and ethnic groups (9.6 percent) needed and received specialty treatment for illicit drug or alcohol use (Figure 2). Among those in need of alcohol treatment, blacks were more likely than persons from other racial and ethnic groups to receive specialty treatment for alcohol use (13.5 vs. 7.6 percent). Similarly, among those in need of illicit drug use treatment, blacks were more likely than persons from other racial and ethnic groups to receive specialty treatment for illicit drug use (21.3 vs. 17.3 percent).

Figure 2. Receipt of Specialty Substance Use Treatment in the Past Year among Blacks Aged 12 or Older in Need of Treatment, Compared with Persons of Other Races/Ethnicities: 2003 to 2011
This is a bar graph comparing receipt of specialty substance use treatment in the past year among blacks aged 12 or older in need of treatment, compared with persons of other races/ethnicities: 2003 to 2011. Accessible table located below this figure.

Figure 2 Table. Receipt of Specialty Substance Use Treatment in the Past Year among Blacks Aged 12 or Older in Need of Treatment, Compared with Persons of Other Races/Ethnicities: 2003 to 2011
Races/Ethnicities Received Alcohol
Use Treatment*
Received Illicit Drug
Use Treatment*
Received Illicit Drug
or Alcohol Use Treatment*
Blacks 13.5% 21.3% 15.2%
Persons of Other Races
   and Ethnicities
  7.6% 17.3%   9.6%
*Difference between blacks and persons of other races and ethnicities is significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health (NSDUHs), 2003 to 2005, 2006 to 2010 (revised March 2012), and 2011.


Self-Perceived Need for and Efforts Made to Receive Specialty Treatment

An estimated 2.2 million blacks needed but did not receive specialty substance use treatment in the past year, compared with 18.4 million persons for other racial and ethnic groups. Among blacks who needed but did not receive substance use treatment, 92.0 percent did not feel the need for treatment, 5.2 percent felt the need for treatment but did not make an effort to get it, and 2.8 percent felt the need for treatment and made an effort to get it (Figure 3). In comparison, among persons from other racial and ethnic groups, 95.1 percent did not feel the need for treatment, 3.5 percent felt the need for treatment but did not make an effort to get it, and 1.4 percent felt the need for treatment and made an effort to get it.

Figure 3. Past Year Perceived Need for and Effort Made to Receive Specialty Treatment among Blacks Aged 12 or Older Needing but Not Receiving Substance Use Treatment, Compared with Persons of Other Races/Ethnicities, Aged 12 or Older: 2003 to 2011
This is a pie chart comparing past year perceived need for and effort made to receive specialty treatment among blacks aged 12 or older needing but not receiving substance use treatment, compared with persons of other races/ethnicities, Aged 12 or Older: 2003 to 2011. Accessible table located below this figure.

Figure 3 Table. Past Year Perceived Need for and Effort Made to Receive Specialty Treatment among Blacks Aged 12 or Older Needing but Not Receiving Substance Use Treatment, Compared with Persons of Other Races/Ethnicities, Aged 12 or Older: 2003 to 2011
Races/Ethnicities Blacks Persons of Other Races and Ethnicities
Did Not Feel They Needed Treatment 92.0%* 95.1%
Felt They Needed Treatment and Made an Effort   2.8%*   1.4%
Felt They Needed Treatment and Did Not Make an Effort   5.2%*   3.5%
* Difference between blacks and persons from other races and ethnicities is significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health (NSDUHs), 2003 to 2005, 2006 to 2010 (revised March 2012), and 2011.


Demographic Characteristics of Individuals Needing and Receiving Treatment

Blacks who were 12 to 17 or 18 to 25 years of age were less likely than persons in the same age groups from other racial and ethnic groups to need specialty treatment (Table 1). Compared with their counterparts in other racial and ethnic groups, blacks aged 26 or older were more likely to need specialty treatment and were more likely to receive it. Black females were less likely than females of other racial and ethnic groups to be in need of treatment (5.4 vs. 6.5 percent), but black males were more likely to need treatment than males of other races and ethnicities (13.5 vs. 12.3 percent).

Table 1. Need for and Receipt of Treatment at a Specialty Facility for Substance Use in the Past Year among Blacks Aged 12 or Older, Compared with Persons from Other Races/Ethnicities, by Demographic Characteristics: 2003 to 2011
Demographic Characteristic Needed
Substance Use
Treatment:
Blacks
Needed Substance Use
Treatment: Persons
of Other Races and
Ethnicities
Received Substance
Use Treatment:
Blacks Who Needed
Treatment
Received Substance Use
Treatment: Persons of Other
Races and Ethnicities Who
Needed Treatment
Total   9.1%    9.3% 15.2%*   9.6%
Aged 12 to 17   5.3%*   8.5%   7.4%    8.1%
Aged 18 to 25 15.3%* 22.1%   7.7%    7.5%
Aged 26 or Older   8.4%*   7.3% 19.1%* 10.9%
Male 13.5%* 12.3% 15.6%*   9.8%
Female   5.4%*   6.5% 14.5%*   9.3%
Less than 100% Federal
   Poverty Level (FPL)**
11.7%* 12.8% 20.4%  17.5%
100%-199% FPL**   9.1%    9.6% 14.7%  12.3%
200% or More FPL**   7.7%*   8.5% 11.6%*   7.6%
Health Insurance Coverage   7.7%*   8.3% 15.4%*   8.7%
No Health Insurance
   Coverage
15.9%  15.5% 14.8%  12.6%
* Difference between blacks and persons of other race/ethnicities is significant at the .05 level.
** Estimates are based on a definition of the Federal Poverty Level that incorporates information on family income, size, and composition and is calculated as a percentage of the U.S. Census Bureau's poverty thresholds. Respondents aged 18 to 22 who were living in a college dormitory were excluded. Estimates for poverty are only based on 2005 to 2011 data.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health (NSDUHs), 2003 to 2005, 2006 to 2010 (revised March 2012), and 2011.

Among those with incomes less than 100 percent of the Federal Poverty Level, blacks were less likely than persons from other racial and ethnic groups to need substance use treatment (11.7 vs. 12.8 percent) but no more likely to receive treatment if they needed it. Among those with incomes greater than 200 percent of the Federal Poverty Level, blacks were less likely than persons from other racial and ethnic groups to need treatment (7.7 vs. 8.5 percent) but more likely to receive treatment if they needed it (11.6 vs. 7.6 percent). Blacks with health insurance coverage were less likely to need specialty treatment (7.7 vs. 8.3 percent) and more likely to receive treatment if they did need it (15.4 vs. 8.7 percent).


Discussion

SAMHSA aims to reduce the impact of substance abuse and improve access to quality behavioral health services and support. This report shows that blacks are more likely to need illicit drug use treatment than individuals from other racial and ethnic groups. Among those who needed treatment for illicit drug or alcohol use in the past year, blacks are more likely than persons from other racial and ethnic groups to receive specialty treatment. Blacks with a substance use problem are more likely to recognize their need for treatment and more likely to make an effort to receive specialty treatment. This report highlights variations in substance use treatment need and receipt between blacks and persons of other racial and ethnic groups. The findings presented here may help guide efforts to address access to specialty treatment facilities and outreach programs for the black population.


End Notes
1 Humes, K. R., Jones, N. A., & Ramirez, R. R. (2011, March). Overview of race and Hispanic origin: 2010 (Census Brief C2010BR-02). Washington, DC: U.S. Department of Commerce, Economics and Statistics Administration, U.S. Census Bureau.
2 U.S. Department of Health and Human Services. (2011, April). HHS action plan to reduce racial and ethnic health disparities: A Nation free of disparities in health and health care. Washington, DC: Author.
3 Illicit drugs include marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type psychotherapeutics used nonmedically, including data from original methamphetamine questions but not including new methamphetamine items added in 2005 and 2006.
4 NSDUH defines dependence on or abuse of alcohol and illicit drugs using criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), which include such symptoms as withdrawal, tolerance, use in dangerous situations, trouble with the law, and interference with major obligations at work, school, or home during the past year. For details, see: American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
5 Substance use treatment at a specialty facility is defined as treatment received at drug or alcohol rehabilitation facilities (inpatient or outpatient), hospitals (inpatient services only), and mental health centers; it excludes treatment received in an emergency room, private doctor's office, self-help group, prison or jail, or hospital as an outpatient.
6 NSDUH asks a series of questions about race/ethnicity. First, respondents are asked about their Hispanic origin; then they are asked to identify which racial grouping best describes them: white, black/African American, American Indian or Alaska Native, Native Hawaiian, other Pacific Islander, Asian, or other. Respondents may select more than one race. For this report, respondents identifying themselves as Hispanic were assigned to the other race/ethnicity group regardless of their racial identification. Black or African American refers to persons identifying themselves as black or African American only. Persons identifying themselves as black or African American and another racial group are included in the category of persons selecting two or more races.


Suggested Citation
Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (February 21, 2013). Need for and Receipt of Substance Use Treatment among Blacks. Rockville, MD.

The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The 2003 to 2011 data used in this report are based on information obtained from 2.7 million non-Hispanic African Americans (blacks) aged 12 or older, and 20.4 million non-blacks aged 12 or older. The survey collects data by administering questionnaires to a representative sample of the population through face-to-face interviews at their place of residence.

The NSDUH Report is prepared by the Center for Behavioral Health Statistics and Quality (CBHSQ), SAMHSA, and by RTI International in Research Triangle Park, North Carolina. (RTI International is a trade name of Research Triangle Institute.)

Information on the most recent NSDUH is available in the following publication:

Center for Behavioral Health Statistics and Quality. (2012). Results from the 2011 National Survey on Drug Use and Health: Summary of national findings (HHS Publication No. SMA 12-4713, NSDUH Series H-44). Rockville, MD: Substance Abuse and Mental Health Services Administration.

Also available online: http://www.samhsa.gov/data/NSDUH.aspx.

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